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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US">Dear Xavier<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US">Thank you for being skeptical. Science works on challenges,
<i>nullis in verba</i>.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">On the IAP matter in UB, there are generalisations one can make and specific circumstances worth noting. There is a study of the effect on indoor air pollution
from the improved stoves (Korean study, available in English). The concluded that the improved stoves which reduce PM2.5 output by 90-98%
<i>increased </i>indoor air pollution, which was so unbelievable that I bothered to investigate the study quite carefully.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">What I found was that they did indeed measure an increase, on average, in IAP but: the difference was well inside their margin of error (a small fraction of the
variations measured, rendering the conclusion meaningless. Further, on those days when they were measuring, the ambient (outdoor) air pollution closely matched the claimed indoor air quality, save that in every case the IAP was lower than the OAP. In short,
all the Koreans measured was the effect on IAP from outside air.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">The worst aspect of the paper was that they claimed a statistically significant difference: the new stoves provided worse IAP than the old stoves – which the numbers
did not support at all. There <i>was</i> a difference in the averages, and the new stove measurements were higher, but the difference was a small fraction of the Sigma 1 of their numbers, which is to say, the difference was
<i>not</i> statistically significant. <o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Decent chimney stoves with a correctly fitted chimney have very little effect on IAP. We have ample recent evidence of this in Kyrgyzstan if there was any doubt.
Improper operation can lead to fugitive emissions from the stove – for example leaving the ash drawer open a bit ‘to give more power’ breaks the draft from the chimney and the top surfaces can leak smoke into the room as they are no longer under negative pressure.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">There is correlation between OAP and IAP and infections, but they are associations, not causal relationships. We can ask Nikhil about which words to use exactly.
The claim that 4.3m people ‘die from air pollution’ per annum is clearly false and a misrepresentation of the published evidence used to support the claims that air pollution shortens lives – by attribution (not medical evidence).<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">« Children in Ulaanbaatar, are taken bronchitis in 1.4-2.7 times and bronchitis asthma in 5.5-7.9 times more than children who are living in rural areas of less
air pollution. » says Social Health institute. </span><span lang="EN-US" style="font-family:"Calibri",sans-serif"><a href="http://www.unoosa.org/documents/pdf/psa/activities/2006/graz/presentations/0102.pdf">http://www.unoosa.org/documents/pdf/psa/activities/2006/graz/presentations/0102.pdf</a></span><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">
p 12.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Who simple is this statement? Did anyone measure IAP in the rural areas where they burn dung for heating and cooking? Many people in the rural areas are reasonably
well fed and clothed. A lot of people in Ulaanbaatar were driven there by absolute poverty and live in desperate conditions, some depending on coal vouchers to obtain fuel. How did the temperature of the home affect the incidence, and what is the socioeconomic
conditions of the families with high occurrence? Are there bronchitis epidemics in town that do not occur in rural areas because the possibility of transmission is so much lower? Yes the OAP is much lower in rural areas, but is their exposure to smoke, for
example, lower or higher?<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-top:12.0pt"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">When the Kyrgyz villagers were keeping their homes free of IAP (with chimneys and non-leaking stoves)
<i>and 5 degrees warmer</i> the incidence of bronchitis dropped to zero (51 homes, 2016-17 season). I interviewed parents in February in the Naryn region and they all said before they got the new stove the children were “sick all winter” before and “much sicker
than this winter” and so on. Chronic cold spreads disease among children. Bronchitis is a bacterial infection. PM2.5 is sterilized. So you are looking for pre-dispositions caused by PM2.5, not ‘causes’.
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif">It is dusty pretty much everywhere. The city is definitely smokier, and it can be quite bad if the wind drops, because below -30 the city is colder than the mountains
around, or communities at higher elevation such as nearby Nalaikh where the coal comes from. Prof Lodoysamba confirmed the ‘colder’ hypothesis this winter using a pretty sophisticated monitoring station at his home in Nalaikh with thermometers at different
heights above the ground. The city, below -30, is colder, smokier, has a poorer diet and more fugitive dust than rural areas. But a traditional stove burning dung can be pretty smoky, and we have zero measurement of IAP in rural homes.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">«So we concluded that the level of urban air pollution in the capital city is clearly having an adverse impact on the pulmonary health of urban Mongolian
children.»</span><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">They can conclude that but that is no proof. That is an association. It is why Nikhil keeps pointing out that you cannot make claims for causes and avoidances without knowing
a heck of a lot about the sub-population you are examining. Attributing something as a cause does not mean that removing the attributed cause avoids the problem. Suppose the attribution was in error by 80%?<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Regarding proximity to highways: who lives next to noisy and polluted highways in California: the well fed and exercised with good medical treatment? Or poor people with poor
health coverage, bad diets and no access to recreational facilities? Correlation is not causation.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">“</span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">UNICEF says: « Outdoor air pollution is the most significant environmental risk
faced by children in Ulaanbaatar.</span><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">”</span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Hmm… Is alcohol an environmental risk? What about smoking? The air pollution is awful on some days, and visible, and variable from place to place. There must be children
for whom it is the worst environmental risk, and others for whom it is now. The point is that we can remove virtually all of it with improved combustion of the very same fuels they now use. The major impediment to achieving this is the parade of baseless claims
that coal cannot be burned cleanly, and therefore they must ban it – the only fuel available at a price they can afford. The sheer stupidity of blaming the fuel for the performance of the stove cannot have a greater effect on the people. Those advocates of
fuel bans based on the misbelief that the fuel is the problem, are partnering with the advocates of ‘alternatives’ costing multiple times as much and which provide no additional benefit save in some cases, convenience. Free electricity is lovely – if the nation
can afford it. No nation I know of can, so how can Mongolia? Other countries are now depending on the great progress made in coal stove designs from Mongolia. How is it possible that the Mongolians are deprived of the benefits of this work? Advocates, that’s
how. Advocators of heat pumps, subsidised electricity, dimethyl ether, natural gas, LPG, wood pellets, processed coal – every and anything that costs a lot, but not ultra-clean-burning coal stoves developed right up the road
<i>in a university-owned, government-supported stove development centre</i>!<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">“</span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">For bronchitis, this study points to indoor smoking from parents as the main
source of children’s bronchitis cases:</span><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">”</span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">That is unbelievable. The “main source”? The cause? That is a clear claim that second hand smoke causes bronchitis.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">“</span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">I didn’t see anywhere that respiratory diseases were due to the cold in Mongolia.</span><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">”</span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Think about that. The record low for Ulaanbaatar is -54 C (2002). The annual average is -2C. Is it possible that people earning $2500 per year live in a chronically underheated
home? Ya think??<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« With 50 % of the ambient PM pollution (and more in the winter months) originating from household stoves for cooking and heating, this sector tops
the list of the most opportunistic of the interventions for better air quality. »<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">That is 2013. Times have changed. The stove programme was in full swing in 2013. The % dropped from 88% (2010) in one district to an average of 45% in 2015 (in winter). In
summer the air is very clean (12 </span><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">µ</span><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">g/m<sup>3</sup>, for example).<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">So, if « 7 million deaths » from WHO may be far fetched, it seems reasonable to me to call for cleaner stoves.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">And, in the case of Ulan Bator, to sensitize people against indoor smoking: is it actually being done?<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Preaching against smoking is everywhere. The number f people smoking in developing countries is increasing rapidly because they are targeted by vendors. The advertising has
been driven out of developed country media. It is <i>very</i> reasonable to call for clean stoves. Very clean. Why not? The benefits are huge, but it is not the entire problem. Without doubt the strangest country I have worked in is Mongolia because the clean
burning solutions were developed there, tested there, supported financially yet are maligned for political purposes. Everyone wants to blame others for “not solving the air pollution problem”. After the stove replacement programme stopped at the end of 2015,
air pollution was down 65%. Some say 45% depending on where you measure it. It was improved
<i>uuugely</i>. Yet people popped up to say nothing was achieved by the programme. Short memories.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">I am sure asthma attacks decreased because air pollution aggravates asthma. I do not have stats, however. It just seems likely. Now we need to address the low pressure boilers
which are more and more common and burn 4 times as much fuel as the ger stoves, at least. They were not included in the ger stove programme. We are working on the at the moment. Products were tested last week – efficiency was too high. I will reduce it.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">In the meantime, Kyrgyzstan starts rolling out improved stoves (locally made) to 14,000 homes, slowly at first. The coal combustors are all based on the Mongolian developments.
South Africa localised the design and we have a model ready for testing since last Monday. It is a beauty, and will incorporate lessons learned from the use of the plastic refractory materials in Ulaanbaatar last year. It is a game-changer.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Keep pushing! Rocks don’t move by themselves.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Crispin<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Hello Crispin,<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">So you say IAP wouldn’t change much if stoves were electrical.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">What about Outdoor Air Pollution (OAP)? Isn’t most of it in Ulan Bator from stoves and cars?<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">I googled about the issue. I have to admit I was skeptical at first about the absence of farm animals being correlated to the frequency of asthma cases,
or the importance of smoking indoor.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">But actually, I couldn’t find a lot of studies pointing very clearly at the relationship between OAP and respiratory infections.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Well, you probably know all the studies about Mongolia already.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« Children in Ulaanbaatar, are taken bronchitis in 1.4-2.7 times and bronchitis asthma in 5.5-7.9 times more than children who are living in rural areas
of less air pollution. » says Social Health institute.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.unoosa.org%2Fdocuments%2Fpdf%2Fpsa%2Factivities%2F2006%2Fgraz%2Fpresentations%2F01-02.pdf&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741366959&sdata=Fm90hzSdHMSOB8HvFKH9xxARTXfibqXZQN%2BIrk4GAeQ%3D&reserved=0">http://www.unoosa.org/documents/pdf/psa/activities/2006/graz/presentations/01-02.pdf</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">p 12.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">So, is it because of the OAP of the city, or the fact they live in the city and far from farm animals, and so built weaker immune systems? Or because
of the cold (colder in Ulan Bator ?!), or dust (dustier ?).<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Litterature seemed indeed to point that children build asthma defenses when they live close to farm animals (in rural regions). While when living in
cities, there are more admissions in hospitals due to asthma.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F17298344&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=uTSNM0lu%2Fjm8olkP6TMYdsM372%2BeoZQ0NB3TmM19NmY%3D&reserved=0">https://www.ncbi.nlm.nih.gov/pubmed/17298344</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">This one attributes a bit quickly:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« Importantly the lung function of the children on the steppe was significantly better than those living in Ulaanbaatar. So we concluded that the level
of urban air pollution in the capital city is clearly having an adverse impact on the pulmonary health of urban Mongolian children. »<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4043223%2F&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=uuilh%2B27MOwl44EFbbs5bAToviZpy1HlJrnI53A8g28%3D&reserved=0">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043223/</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">It also says:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« Similar patterns of adverse health risk such as asthma, obesity and autism in proximity to freeways and major roads have previously been well documented
by us and our colleagues in Los Angeles, CA. »<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">The study seems to show that depending on the world region, different factors are involved in allergies:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fpdfs.semanticscholar.org%2F7dca%2F35da8463d9c600f3651e1bb77ab3af259fc7.pdf&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=SVz%2Bq2FAfo9qqXNyAg9BrfJD34dHAOxrhRboVP%2FRGYg%3D&reserved=0">https://pdfs.semanticscholar.org/7dca/35da8463d9c600f3651e1bb77ab3af259fc7.pdf</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">For bronchitis, this study points to indoor smoking from parents as the main source of children’s bronchitis cases:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4835771%2F&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=0z1a%2B7e%2B%2FowdVlBuP9oXh%2FbBWvMgBLqWDSm%2B4dP9vIQ%3D&reserved=0">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835771/</a>
-> but it is in a rural area. It doesn’t explain why there are more cases in Ulan Bator. Seems unlikely that people smoke more in urban areas?<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">It does not exclude the influence of IAP from stoves, and refers to a study saying that stoves contributes a lot to IAP.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">This one, in Ulan Bator, points to both indoor smoking and air pollution:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS1323893015001586&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=wxr4wxDIRPYAQZhQ5o3tbzbwYM6LbdQ%2FAaWJwTekRmE%3D&reserved=0">https://www.sciencedirect.com/science/article/pii/S1323893015001586</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">This one puts again indoor parental smoking and IAP from stoves as probable causes, and maybe outdoor air pollution:
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fjournals.lww.com%2Fepidem%2Ffulltext%2F2011%2F01001%2FIndoor_Air_Pollution_in_Different_Mongolian.96.aspx&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=nQupZ%2F3mS0lt4As7KirDvg7SDncl8dqbWTMlOsVtzso%3D&reserved=0">https://journals.lww.com/epidem/fulltext/2011/01001/Indoor_Air_Pollution_in_Different_Mongolian.96.aspx</a><o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">UNICEF says: « Outdoor air pollution is the most significant environmental risk faced by children in Ulaanbaatar. »<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.unicef.org%2Fmongolia%2FMongolia_air_pollution_crisis_ENG.pdf&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=4ua91l%2Ba3SLco0Hu5W5jIsmYkWy9%2FtbxaeBzTGO5vm8%3D&reserved=0">https://www.unicef.org/mongolia/Mongolia_air_pollution_crisis_ENG.pdf</a><o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">There seem to be a long list of medical studies (page 86) saying that air pollution has an effect on children’s health, and even that OAP does:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.unicef.org%2Fpublications%2Ffiles%2FUNICEF_Clear_the_Air_for_Children_30_Oct_2016.pdf&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=oeOdbJUbP9LoypDuN%2FiL91vKTTg19%2BMkwetn%2BHg74lg%3D&reserved=0">https://www.unicef.org/publications/files/UNICEF_Clear_the_Air_for_Children_30_Oct_2016.pdf</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">There are studies correlating OAP and respiratory diseases in other parts of the world:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F22871325&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741523205&sdata=RFATlX87u2v46ugKKXbQrULRf6HHzjKC%2BFU874Lgd1E%3D&reserved=0">https://www.ncbi.nlm.nih.gov/pubmed/22871325</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.jacionline.org%2Farticle%2FS0091-6749(17)32516-2%2Ffulltext&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=96r%2F94JgIyrymTsn6euDyjvPhvw08OxLQLdg79ev9Es%3D&reserved=0">https://www.jacionline.org/article/S0091-6749(17)32516-2/fulltext</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">I didn’t see anywhere that respiratory diseases were due to the cold in Mongolia.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Regarding dust: there are more diseases in Ulan Bator than in rural areas, yet the latter are more dusty (are they?). And Ulan Bator is far from the
Gobi desert, correct?<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F21488467&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=ND3WFE9miFpYSLbx2AoZMCBOASHdCpZkgo6Bq6qtEXw%3D&reserved=0">https://www.ncbi.nlm.nih.gov/pubmed/21488467</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">This study looks at all the sources of air pollution, among which dust and ash ponds. It still concludes:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« With 50 % of the ambient PM pollution (and more in the winter months) originating from household stoves for cooking and heating, this sector tops
the list of the most opportunistic of the interventions for better air quality. »<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.urbanemissions.info%2Fwp-content%2Fuploads%2Fdocs%2F2013-09-AQAH-Ulaanbaatar-PM-Pollution.pdf&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=xu0QoGtNeFL8DdT99xeJKTjPWyoUIih7ChaiO9NTKqI%3D&reserved=0">http://www.urbanemissions.info/wp-content/uploads/docs/2013-09-AQAH-Ulaanbaatar-PM-Pollution.pdf</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">You’re quoted a bit below Crispin BTW.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Are there meta-analysis of medical studies on the correlation between OAP and respiratory diseases? It seems to me we don’t know for sure to what extent
each factor contributes to diseases and mortality. But we have good hints that the main factors may be:<o:p></o:p></span></p>
<ul style="margin-top:0cm" type="disc">
<li class="MsoListParagraph" style="color:#1F497D;margin-left:0cm;mso-list:l0 level1 lfo2">
<span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">OAP and IAP from stoves<o:p></o:p></span></li><li class="MsoListParagraph" style="color:#1F497D;margin-left:0cm;mso-list:l0 level1 lfo2">
<span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">indoor smoking<o:p></o:p></span></li></ul>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">To me there seems to be only a handful of factors. That means that solutions are relatively straight-forward.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">So, if « 7 million deaths » from WHO may be far fetched, it seems reasonable to me to call for cleaner stoves.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">And, in the case of Ulan Bator, to sensitize people against indoor smoking: is it actually being done?<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">News are always alarmist. We see « 7 million deaths because of air pollution!!! » because we work in stoves, but in the news, there are also:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« 6 million deaths because of smoking!!! »<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.popsci.com%2Fsmoking-is-still-bad-for-you&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=7BzPDe726CuQWpodlHquZn2OW85yW9Rd3%2FsK%2B%2BYEgK0%3D&reserved=0">https://www.popsci.com/smoking-is-still-bad-for-you</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">« Poor diet is a factor in one in five deaths !!! »<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.theguardian.com%2Fsociety%2F2017%2Fsep%2F14%2Fpoor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=uUO9ArGmaQ7fUZ7UYfs4SjB1%2F9tv1y4aO7yTHb2BvHs%3D&reserved=0">https://www.theguardian.com/society/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">That’s true, news tend to make us think that the main cause of mortality in Mongolia is air pollution. But if we go through a few articles, we see they
actaully also talk about other causes:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.mcc.gov%2Four-impact%2Fstory%2Fstory-preventing-mongolias-leading-killers&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=K1s1NgrWk4kvzU3ksNTNVsWxag60xM4JancKcy6oLpM%3D&reserved=0">https://www.mcc.gov/our-impact/story/story-preventing-mongolias-leading-killers</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.theguardian.com%2Fglobal-development%2F2017%2Fnov%2F07%2Fmongolia-liver-cancer-crisis-no-other-country-has-a-problem-like-this&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=WUKaP0ZWLNurVZp3K9WyKg9d5pP3y1LlYQSNfruv3Gw%3D&reserved=0">https://www.theguardian.com/global-development/2017/nov/07/mongolia-liver-cancer-crisis-no-other-country-has-a-problem-like-this</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.theguardian.com%2Fworld%2F2013%2Foct%2F20%2Fulan-bator-killer-winter-stoves&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=wcKXj4VdynBUzEcIg5OsdfrUGaVqKRsX5yBxyYk7qKU%3D&reserved=0">https://www.theguardian.com/world/2013/oct/20/ulan-bator-killer-winter-stoves</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">News also talk more about respiratory diseases, because many children suffer from it.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><a href="https://eur01.safelinks.protection.outlook.com/?url=http%3A%2F%2Ftime.com%2Flongform%2Fulan-bator-mongolia-most-polluted-capital%2F&data=02%7C01%7C%7C913c931ab731422abf2308d5b526d449%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636614100741679462&sdata=AUciNXnWCxRu3Io9RPdGW8Xqr6VZBttnEpdPTU%2BPMyE%3D&reserved=0">http://time.com/longform/ulan-bator-mongolia-most-polluted-capital/</a>
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">It is understandable that even if these diseases are not the major killer at the population level, they are still given a higher priority by public
deciders, than, say, heart diseases which strike mostly adults.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">So human lives are shortened by a number of diseases. There is a number of causes for these diseases. And we are working on one of these causes: stoves.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">So I agree, there is no need to be alarmist, and to exagerate or misrepresent a truth which is, actually, already quite alarming. But the fact that
the situation is a bit more complex than the one presented the WHO reports or the newspapers doesn’t mean air pollution isn’t a serious issue. And that we shouldn’t be working on that issue with the highest possible energy.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Best,<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Xavier<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<div>
<div style="border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0cm 0cm 0cm">
<p class="MsoNormal"><b><span lang="FR" style="font-size:10.0pt;font-family:"Tahoma",sans-serif">De :</span></b><span lang="FR" style="font-size:10.0pt;font-family:"Tahoma",sans-serif"> Stoves [mailto:stoves-bounces@lists.bioenergylists.org]
<b>De la part de</b> Crispin Pemberton-Pigott<br>
<b>Envoyé :</b> lundi 7 mai 2018 03:05<br>
<b>À :</b> Discussion of biomass cooking stoves<br>
<b>Objet :</b> Re: [Stoves] Air pollution kills<o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><span lang="FR"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">Dear Xavier<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">Let’s take Ulan Bator. There are 1.5 million inhabitants.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D">If all of them were using electrical heating and cooking, and driving bicycles instead of cars:<o:p></o:p></span></p>
<ul style="margin-top:0cm" type="disc">
<li class="MsoNormal" style="color:#1F497D;mso-list:l1 level1 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">would we likely see less indoor and outdoor air pollution?<o:p></o:p></span></li><li class="MsoNormal" style="color:#1F497D;mso-list:l1 level1 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">would we likely see less cases of respiratory infections like bronchitis, pneumonias, etc.?<o:p></o:p></span></li><li class="MsoNormal" style="color:#1F497D;mso-list:l1 level1 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">would the respiratory infections cases likely be less acute?<o:p></o:p></span></li><li class="MsoNormal" style="color:#1F497D;mso-list:l1 level1 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">would there likely be less cases of deaths due to a respiratory infection?<o:p></o:p></span></li><li class="MsoNormal" style="color:#1F497D;mso-list:l1 level1 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">would the life expectancy of the population likely be higher?<o:p></o:p></span></li></ul>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<ul style="margin-top:0cm" type="disc">
<ol style="margin-top:0cm" start="1" type="1">
<li class="MsoNormal" style="mso-list:l1 level2 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">There isn’t much air pollution now indoors so it would probably not be reduced. In a home where no one smokes and they have a typical
Stove Programme stove, the majority of IAP is caused by smoking and cooking. In the case of IAP in gers (yurts) the indoor air is generally better than the ambient air outside.<o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level2 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Respiratory infections are greatly influenced by the temperature in the home and seasonal flu. Assuming people would not be heating
their homes any higher than they are now (which means ‘chronically cold all the time’) the rate would probably not change much. This was demonstrated in Kyrgyzstan when it was shown that increasing the average temperature 5 degrees and heating for more than
16 hrs per day instead of 2-6 there was a huge medical health benefit – nothing to do with smoke. Being chronically cold in a stove-smoke-free environment would help reduce eye irritation and asthma attacks, I think.
<o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level2 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">I can’t see the acuteness of the infections being much affected with an annual average PM2.5 of 160 microgrammes, if nothing is done
to address the chronic underheating issue. Mostly children get sick, and they get sick because they are cold so much of the time, or are subjected to large changes in temperature all day from traditional stoves going from zero to 40 kW then back to zero. Electric
heating would moderate that, presumable, but you described changing the energy source, not the temperature profile.
<o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level2 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">About the deaths, this is the same as Q3 about acute problems. Remember that changing the energy sources for a few things doesn’t
change all the other sources of air pollution : ash ponds, the Gobi Desert, and vehicles. Using electric vehicles would remove about 50% of the PM2.5 downtown, but not the considerable fugitive dust created by those vehicles on dirt roads. Dust storms are
50 times worse than air pollution from people. Construction dust is considerable. Stove smoke is only about 45% of the total. It used to be 88% in some areas.<o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level2 lfo5"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">The life expectancy is affected negatively by a lot of things other than air pollution : alcohol is a big problem, the diet consists
largely of meat and fat is appreciated, the average income is very low, there is a great reliance on traditional medicine. There are a great many car accidents and falls from horses. Here are the top 25 causes of death in Mongolia (I don’t have it for UB
alone) :<o:p></o:p></span></li></ol>
</ul>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR"><img border="0" width="227" height="460" style="width:2.3645in;height:4.7916in" id="Picture_x0020_1" src="cid:image001.jpg@01D3E6F3.69DF7550" alt="cid:image001.jpg@01D3E65F.551C5C80"></span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Which of those are related to diet and what is the first on the list that might be contributed to by air pollution? A lot of people
smoke and smoke indoors. Breathing the city air is on average like smoking a 1/28th of a cigarette per day – the same as Calcutta.<o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">So how do Mongolian causes of death rank in the world?<o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR"><img border="0" width="227" height="371" style="width:2.3645in;height:3.8645in" id="Picture_x0020_2" src="cid:image002.jpg@01D3E6F3.69DF7550" alt="cid:image002.jpg@01D3E65F.551C5C80"></span><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Number 1 for liver cancer, stomach cancer and number three for suicide and stroke. Do you see any diet-related diseases there cause
by consuming a large amount of meat and alcohol?<o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left:72.0pt"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">They have a very low global ranking for breast and prostate cancer and diabetes (all >170).
<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">All things considered, it would be much better if there were no air pollution in the city, but is it a major killer, or
<i>the</i> major killer? Doesn’t look like it.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Bright side :<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Improving the domestic combustion devices greatly reduces indoor and outdoor air pollution, saves money, increase the comfort level, being warm greatly reduces the
incidence of bronchitis, and makes people a lot happier. Those are reasons enough to support stove programmes. Given the context, it is not going to make much difference to the premature death rate from ambient air pollution. Moving people from gers to heated
apartments increases their IAQ problems because so many people smoke and the apartments have a low air change rate. It is never simple and context is everything.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Never assume anything.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif">Crispin<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span lang="FR" style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p>
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